Individual
JAYNE C. OVERHOLT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
5290 MILITARY RD, SUITE #3, LEWISTON, NY 14092-1953
(716) 297-0052
(716) 297-4530
Mailing address
5290 MILITARY RD, SUITE #3, LEWISTON, NY 14092-1953
(716) 297-0052
(716) 297-4530
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F3809201
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07152689
—
NY
Enumeration date
02/17/2006
Last updated
07/08/2007
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